Rationale, aims and objectives Financial conflicts of interest (FCOI) between pharmaceutical companies (Pharma) and healthcare domains may unduly influence physician-led clinical practice and patient-centered care. However, the extent of awareness and perceptions of FCOI among Japanese cancer patients remains unclear. This study aimed to assess these factors and their impacts on physician trustworthiness among Japanese cancer patients. Methods A cross-sectional study using self-administered surveys was conducted on a Japanese cancer patient advocacy group with 800 registered members from January to February 2019. Main outcome measures included awareness and perceptions of physician-Pharma interactions, their impact on physician trustworthiness, and attitudes towards FCOI among professions. We also performed thematic analyses on additional comments responders provided in the surveys. Results Among the 524 invited members, 96 (18.3%) completed the questionnaire. Of these, 69 (77.5%) were cancer patients. The proportion of participants aware of such interactions ranged from 2.1% to 65.3%, depending on the interaction type. Participants were generally neutral on how the interactions would affect physician trustworthiness. A large proportion of participants agreed that these interactions were unethical, could influence physicians’ prescribing behavior leading to unnecessary prescriptions, and negatively affect physician trustworthiness. Qualitative responses (n=56) indicated that patients expected physicians to use sound ethical judgment and avoid accepting incentives. Participants were also concerned about their treatment and the undue influence of FCOI on physicians. Conclusion Most participants were aware of at least one FCOI between Pharma and physicians and perceived them negatively. Further efforts to regulate FCOI appear necessary to protect patient-centered care.

Specific background information on cancer patients affected more severely by crisis and disasters is lacking. We experienced an advanced breast cancer patient whose hospital visits were interrupted for two years due to multiple internal and external factors. These factors need to be taken more into account for breast cancer management.

We experienced the case of a patient with advanced breast cancer who failed to receive comprehensive care despite regular video conferencing with her physician during the COVID-19 pandemic, resulting in delayed detection of liver metastasis. Inter-hospital collaboration is required to provide uninterrupted cancer care to those disproportionately affected by crises.

Among all pediatric hematologist-oncologists (PHOs) certificated by the Japanese Society of Pediatric Hematology/Oncology (JSPHO), 215 PHOs (70.0%) received $908,900 personal payments from 54 pharmaceutical companies between 2016 and 2019. Four-year combined average payments per author was $2,961 (standard deviation: $6,299). While the prevalence of physicians with payments was relatively stable during the study period with 40.4% and 44.6% in 2016 and 2019, the average annual personal payments increased nearly double from $559 in 2016 to $1,096 in 2019, respectively. Payments from the top five companies with the largest total payments accounted for 48.8% of total monetary values.

There are many challenges that can arise while providing home care to a terminally ill patient. Isolation of infected patients was used to prevent COVID-19 infection. In home care, where informal caregivers play an important role, such measures could result in the loss of caregivers.

Patients and their families are discouraged from the restrictions on hospital visits for coronavirus Infection control. This separation might further deteriorate the mental health of both vulnerable patients and their family members. Home care could be a preferable solution to this problem.

Title: The need for a new style of tele-fetal diagnosis with cloud storage in the post-COVID-19 eraAuthors :Yuto Maeda, MD2-12-13-201, Takanawa, Minato-Ku, Tokyo 108-0074Medical Governance Research Institute, Tokyo, JapanAkihiko Ozaki, MD, PhD57 Kaminodai, Kamiyunagaya-cho, Jyoban, Iwaki city, Fukushima, JapanDepartment of Breast Surgery, Jyoban Hospital of Tokiwa Foundation, Iwaki, Fukushima, JapanTetsuya Tanimoto, MD1-2-27, Shinonome-honmachi, Minami-ku, Hiroshima-shi, Hiroshima, JapanMNES Inc., Hiroshima, JapanYasuteru Shimamura, MD, PhD1-2-27, Shinonome-honmachi, Minami-ku, Hiroshima-shi, Hiroshima, JapanMNES Inc., Hiroshima, JapanTakahiro Nobuzane, MD, PhD7-1, Mikawa-cho, Naka-ku, Hiroshima-shi, Hiroshima, JapanKatsuki Ladies Clinic Hiroshima Chuo-dori, Hirosima, JapanTakahumi Katsuki, MD, PhD7-1, Mikawa-cho, Naka-ku, Hiroshima-shi, Hiroshima, JapanKatsuki Ladies Clinic Hiroshima Chuo-dori, Hirosima, JapanNaoyuki Kitamura, MD, PhD1-2-27, Shinonome-honmachi, Minami-ku, Hiroshima-shi, Hiroshima, JapanMNES Inc., Hiroshima, Japan

This case report presents one important aspect of promoting ACP in Japanese culture, which is different from Western cultures. The report suggests the possibility that legal support contributes to the promotion of ACP, while considering differences in cultural contexts.

Little is known on how disasters interact in their impacts on patient care. We experienced a breast cancer patient whose initial presentation was delayed for two years due to the COVID-19 pandemic and Typhoon Hagibis. Increasing awareness is needed on the combined impacts of disasters on breast cancer management.

We experienced an advanced breast cancer patient who failed to receive diagnostic imaging despite regular video conferences with her physician during the COVID-19 pandemic, resulting in delayed liver metastasis detection. Recognizing shortcomings of telemedicine and collaboration among medical institutions for uninterrupted cancer care is imperative during the pandemic.

Cancer patients, particularly those post-surgery, are prone to skin infection following immersion in flood waters. We reported secondary surgical site infection in a postoperative 80-year-old post-operation breast cancer patient affected by Typhoon Hagibis. Individualized responses based on individual and environmental risks are crucial to alleviate the damage of disasters.